Study Finds Testosterone Depletion in COVID-19 Male Patients

A new research at University of Mersin and the Mersin City Education and Research Hospital in Turkey, revealed for the first time that over half of male population in the study had lower than normal testosterone levels.

This is the first study to explain that the Covid-19 diseases might cause substantial deterioration to men’s testosterone levels, explaining poorer male prognosis than females. Further, study added that the baseline levels of men’s testosterone decreases substantially, leading to significantly increasing proportion of men ending up in the intensive care unit (ICU). These research findings were published in the peer-reviewed journal The Aging Male.

Testosterone is the principal male sex hormone, which on average decreases by 0.8–2% every year after the age of 40 years. In men aged 40 to 70 years, the prevalence of male hypogonadism (reduction of male sex hormone) ranges from 2.1 to 9.5%.

The rate of male hypogonadism significantly amplifies, ranging from 10 to 80% in several diseases including, diabetes, lungs diseases, heart disease, and digestive diseases, leading to increased mortality in the male population. In hospitalised male population, the prevalence of male hypogonadism is 53.3%. Further, low testosterone levels have been linked with increase rates of infection-related hospitalization and all-cause mortality in male dialysis and ICU patients.

Moreover, ACE2 receptor – responsible for virus binding, presumed to affect the testosterone production which subsequently hyperactivate the immune system, resulting in inflammation and delayed recovery process in SARS-CoV-2 infected patients. Therefore, current study aimed to investigate the effect of blood serum total testosterone and its potential relationship with other laboratory parameters on the prognosis of Covid-19 in SARS-CoV-2 infected male patients.

The research team enrolled up to 438 patients including 221 males aged more than 18 years, each with positive SARS-CoV-2 tests. The study cohort was divided into three sub-groups, namely 46 asymptomatic patients, 129 symptomatic patients who were hospitalized in the internal medicine unit, and 46 patients who were hospitalized in the intensive care unit.

Results revealed that at baseline, blood serum total testosterone level was found to be decreasing, whereas the probability (%) of ending up in ICU and probability (%) of mortality increases significantly. Further, in the 24 patients, who have had serum gonadal hormones test before Covid-19, it was found that the serum total testosterone level significantly decreased from pre-Covid-19 level of 458 ± 198 ng/dl to 315 ± 120 ng/dl at the time of Covid-19 in the patients.

Moreover, about 11 male patients and 7 female patients had died, showing no significance between the two genders. Yet, the study was limited as it had not included a control group of patients with conditions other than Covid-19 due to the restrictions placed on the hospital that they were monitoring the patients in.

“Testosterone is associated with the immune system of respiratory organs, and low levels of testosterone might increase the risk of respiratory infections,” Lead author Selahittin Çayan, Professor of Urology, explained.

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